Development and validation of the Psychological Adaptation Scale (PAS): use in six studies of adaptation to a health condition or risk

Patient Educ Couns. 2013 Nov;93(2):248-54. doi: 10.1016/j.pec.2013.05.006. Epub 2013 Aug 28.


Objective: We introduce The Psychological Adaptation Scale (PAS) for assessing adaptation to a chronic condition or risk and present validity data from six studies of genetic conditions.

Methods: Informed by theory, we identified four domains of adaptation: effective coping, self-esteem, social integration, and spiritual/existential meaning. Items were selected from the PROMIS "positive illness impact" item bank and adapted from the Rosenberg self-esteem scale to create a 20-item scale. Each domain included five items, with four sub-scale scores. Data from studies of six populations: adults affected with or at risk for genetic conditions (N=3) and caregivers of children with genetic conditions (N=3) were analyzed using confirmatory factor analyses (CFA).

Results: CFA suggested that all but five posited items converge on the domains as designed. Invariance of the PAS amongst the studies further suggested it is a valid and reliable tool to facilitate comparisons of adaptation across conditions.

Conclusion: Use of the PAS will standardize assessments of adaptation and foster understanding of the relationships among related health outcomes, such as quality of life and psychological well-being.

Practice implications: Clinical interventions can be designed based on PAS data to enhance dimensions of psychological adaptation to a chronic health condition or risk.

Keywords: Adaptation; Health threat of chronic condition or risk; Outcomes of coping; The Psychological Adaptation Scale.

Publication types

  • Research Support, N.I.H., Intramural
  • Validation Study

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Caregivers / psychology
  • Child
  • Female
  • Genetic Diseases, Inborn / psychology*
  • Humans
  • Male
  • Psychiatric Status Rating Scales*
  • Self Concept
  • Social Adjustment
  • Spirituality